versão On-line ISSN 2078-5135versão impressa ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.101 no.11 Cape Town Nov. 2011

To the Editor: In response to Professor Max Klein's correspondence,1 I am flattered that he noticed the research done but take the opportunity to mention a few missed points.

Most significantly, the research was approved by the ethics committees of both the UCT Health Science Faculty and the Business School. I should be most interested to hear on what grounds he infers the research to be unethical.

To assume from the difficulty in gaining responses that dissatisfaction among junior doctors was not great, is poor analytical thinking by Professor Klein. Normal response rates from email surveys are approximately 3%. We achieved 60% (2 were partially completed) - a statistically acceptable response rate. In fact, the dissatisfaction was demonstrated by the doctors themselves - just over 20% of the junior doctors left their rotation before completion of the contract in the previous year. One needs to question an environment in which 20% of the work force leaves.

It may be interesting to Professor Klein to note that, since the study was completed, Red Cross Hospital has employed 4 additional registrars and adopted some management changes, with the result that burnout in a follow-up study dropped by a statistically significant amount. It appears that the study has indeed helped them.

Professor Klein makes a valuable point that I concede - junior doctors are indeed learning skills; it takes time on the job to learn these skills. It would be a disservice (to both the patients of these doctors and to the doctors themselves) not to make the time available to learn these skills. It is due to our skills that South African doctors are sought after worldwide.

We should remember that South Africa is part of a global village. We need to find innovative ways of retaining hard-earned skills in this country, where they are needed. We can no longer simply keep doing the same things because that's what we're used to.